01 January 2008

I've now been working in the ER for long enough that I feel like I've seen it all. It's not true, not by a long shot, but I am hard to impress. I've removed so many mundane and sexual foreign objects from so many orifices that it generally doesn't rate on the interest meter any more. Sure, it's not an everyday occurrence, but I actually take more pleasure and interest in treating a little girl who swallowed a dime than some deviant who crammed unknown objects up his butt.

So I had entirely forgotten about the most recent sexual device removal until I got a phone call from a very confused urologist today. A few weeks ago, a fellow presented requesting removal of a "male chastity device" which was, um, stuck. I didn't even know such things existed. Apparently, the penis is inserted into a restrictive container and secured in place using a retaining ring locked around the base of the scrotum. It prevents erections, and I gather is a part of submissive roleplay. A quick google search (which I do not recommend for the faint of heart) turned up a surprising number and variety of such devices, but the one this gentleman had on resembled this:It was made of steel and the lock was jammed. It was damned difficult to remove. Ring cutters are no good on steel, being made for soft metals. I have used rotating cutting tools before but they tend to heat up the metal too much. Bolt cutters are ... imprecise and thus difficult to use in the genital region. Ultimately, though, it took our largest and strongest bolt cutters and a fair amount of lubricant to remove the offending device. The patient did not wish the device returned to him, and so after the entire staff had gazed at it in wonderment it was placed in the dirty utility room for disposal.

Or so we thought.

I am not sure exactly in which bin it was deposited, but evidently, a well-intentioned cleaning crew picked it up with the rest of the used surgical instruments, and took it back to central sterile supply, where it was washed and sterilized. I can see why -- being stainless steel, it does look like something that ought to be re-used, and the cleaning guys would be afraid to throw it out, not knowing what it was for. I can only imagine their puzzlement as the techs contemplated this unfamiliar object, and in the end they drew a reasonable conclusion from its shape and included it with one of the urologists' surgical trays, with an explanatory note. I happened to be in the ER when the urologist happened to open up this operative tray to find one unexpected instrument, and called down for an explanation. After a great deal of laughter, the mystery was cleared up and I can only presume the device will finally be disposed of.

21 comments:

Seriously, just trying to maintain some semblance of a respectful tone. The most disturbing part of the whole encounter was that I couldn't get my staff to stop giggling about it. Hysterical as it may be, I felt pretty bad for the patient, who was very humiliated coming to the ER with this sort of problem, and how much worse would it have been if (if?) he knew the staff was ROTFL?

Being on the graveyard shift in Sterile Processing, if we would have found it, we would have been extremely confused - as we are frequently left out of the "new items" communication. I would hope we would have waited and asked the day crew before putting it in (or on for this one) a tray. I'm sure there would have been some fun around it with some of the staff.

No, not from "when I did this kind of stuff." (I don't swing *that* way.) However, back in graduate school there was a nice, albeit rather nerdy guy in my dorm who invested much of his public identity in being "Into BDSM." (Everybody knew it was all a big put-on and he probably wasn't getting any, but it was his thing and it made him feel all manly and whatever to wear a chain with locks on it for a belt on his jeans, have handcuffs on his bedposts, etc, so whatevs).

Anyway, one day he forwarded an erotic story to one of my friends that went into great detail about exactly this kind of device. I'd never actually seen one before except in my mind's eye, thanks to that stupid story.

Respectful tone made post even more hilarious. San Francisco area? Maintenance crew might be able to recycle apparatus as plumbing device. Scrap metal is hot commodity these days. Fun post Doc. Keep up good work on blog.

Shadowfax

About me: I am an ER physician and administrator living in the Pacific Northwest. I live with my wife and four kids. Various other interests include Shorin-ryu karate, general aviation, Irish music, Apple computers, and progressive politics. My kids do their best to ensure that I have little time to pursue these hobbies.

Disclaimer

This blog is for general discussion, education, entertainment and amusement. Nothing written here constitutes medical advice nor are any hypothetical cases discussed intended to be construed as medical advice. Please do not contact me with specific medical questions or concerns. All clinical cases on this blog are presented for educational or general interest purposes and every attempt has been made to ensure that patient confidentiality and HIPAA are respected. All cases are fictionalized, either in part or in whole, depending on how much I needed to embellish to make it a good story to protect patient privacy.

All Content is Copyright of the author, and reproduction is prohibited without permission.